Crisis Pregnancy Issues Related to Genetic Defect, Fetal Anomaly

Pastoral Notes regarding Crisis Pregnancy Issues Related to Genetic Defect, Fetal Anomaly or the Health of the Pregnant Woman
In the current cultural and societal situation in the United States, abortion has been accepted as a legitimate and even routine response to an unplanned pregnancy. Of the 1.5 million abortions performed each year in the United States 90% are performed in the first trimester. The overwhelming majority of these abortions are performed because of reasons that can be generally categorized as social: pressure from boyfriend or parents, pregnancy "interferes" with school or career, financial concerns, etc.

Given the ready acceptance and accessibility of abortion, the issues related to women considering abortion for health reasons - their own or the baby's - are particularly challenging. In many of these cases the pregnancy is very much desired. We have great empathy and compassion for women and couples faced with the anguish of a pregnancy with associated health problems. It is important, however, to be clear about the Church's teaching on abortion and to understand that it applies even in these most difficult cases. The Catechism Catholic states the following:

2270 Human life must be respected and protected absolutely from the moment of conception. From the first moment of his existence, a human being must be recognized as having the rights of a person - among which is the inviolable right to life. 2271 Since the first century the Church has affirmed the moral evil of every procured abortion. This teaching has not changed and remains unchangeable. Direct abortion, that is to say, abortion willed either as an and or a means, is gravely contrary to the moral law.

Over the past year a number of situations have come to our attention that indicate that lay ministers, chaplains, social workers, counselors, religious and clergy who provide pastoral care in parishes and health care settings are facing some complicated and challenging problems. The counsel and care of those in a crisis pregnancy for any reason requires a high degree of sensitivity and skill in presenting the Church's teaching in the context of loving care.This is especially true in cases where the pregnant woman is under pressure to abort because of genetic defect/fetal anomaly or concerns regarding her health.

With advances in pre-natal diagnosis, it is not uncommon for expectant women/couples to learn from their doctor that the possibility exists that their baby is suffering from a genetic problem or fetal anomaly. These women/couples are often advised by their doctors to abort their babies. Following such advice women and their families frequently seek counsel from the Church's representatives. They come often filled with fear and grief-stricken over the news they have received from their doctor. Those to whom they turn have a serious responsibility to speak the truth compassionately and lovingly. It is important that those who give counsel; (1) are confident about and committed to the Church's teaching in the midst of very painful emotions, (2) are able to serve generously in assisting women/couples in living out the truth of Christ.

Notes for Pastoral Ministers:

Ask some simple questions early on in the conversation to ascertain whether the baby is still living or has died in utero. Some families agonize needlessly over what to do when the baby is dead in utero. In the case of a baby that has died in the womb, the judgment that must be relied upon is completely medical. Sadly, some women, because it is the best medical course of action, must carry their deceased child until nature takes its course and they go into labor. Other women undergo medical procedures similar to those used in abortion to remove the remains of a baby that has died prior to birth. If the baby is deceased, these procedures are not to be viewed as an abortion, and are morally acceptable. There are a number of options for the pastoral minister in ministering the care and prayer of the Church to families that experience miscarriage or stillbirth. They are outlined in Pastoral Notes available from the Office for Worship.

If it is clear that the baby is living ( a fetal heart beat is present), but because of a diagnosis of genetic defect/fetal anomaly abortion is mentioned or recommended as an option by a physician, it is important to listen carefully. Often women/couples feel an urgency to make a decision immediately because of pressure from their doctor and/or to relieve the great distress they are experiencing. It is helpful to slow down the entire process and encourage them to take the time to think carefully, to seek a second medical opinion, and to pray. Enabling them to find a doctor who will provide expert care and will support them in choosing life for their child is vital. The Pregnancy Help staff is available to assist with referrals to such doctors.

ft is helpful to put a woman/6ouple in touch with someone else who has given birth to a child with a similar diagnosis. The reality of what to expect, explained by a parent who has had a similar experience, often alleviates the woman's worst fears. An extensive network of practical and emotional support is available for families after the birth of a child with disabilities. Again, the Pregnancy Help staff is available to assist in making such connections. Fear is often the driving force behind a decision to choose abortion in these situations. Anything that can be done to help reduce the level of fear is advantageous for the woman/couple in the midst of such a difficult decision.

Pregnant women who have serious health problems, such as cancer or diabetes, also are often strongly encouraged to abort. Again, reducing feat, taking the time to think and pray through the decision and seeking a second medical opinion and the supportive help of others are of vital importance. Often women are unaware that treatment can effectively be continued that does not compromise the life or health of her unborn baby.

In those rare cases when treatment of the mother endangers the life of the unborn child, the principle of the double effect needs to be explained. This principle allows for an action whose primary aim is good while it can be foreseen, although not intended, that in performing the good act a bad or negative effect may occur. For instance, it is morally licit for a pregnant woman to receive chemotherapy to treat cancer although it may be anticipated that this could also precipitate a miscarriage. In such cases, an evil is foreseen but not intended. It is never licit directly to abort the child as a form of treatment. The U.S. Bishops' Statement on Anencephaly: Origins, October 10, 1997 (Vol. 26: No. 17) and Health Care Ethics, by Benedict M. Ashley,OP and Kevin D. O'Rourke,OP, published by Georgetown University Press, provide a fuller discussion of this topic.

Some pastoral ministers who have counseled couples in these situations believe that the Church's prohibition on abortion is lacking in compassion or "too hard a teaching" in these very difficult situations. But that teaching must be maintained because it is true and truly compassionate. Our experience, both with women who continue to carry such a pregnancy and with those who choose abortion, affirms the soundness and wisdom of the Church's teaching. The aftermath for women who choose abortion because of fetal anomaly often leads to profound and unrelenting grief, sorrow and regret. The emotional and spiritual pain of the death of their child, which in many cases would have occurred during the natural course of the pregnancy or shortly after birth, is only intensified by the decision for abortion.

It is not only a form of false mercy, but often confusing and dispiriting to those seeking counsel, for pastoral ministers to express ambivalence about the Church's teaching in the midst of the person's crisis. The message of tacit approval of a decision to abort is neither a pastoral service nor a compassionate response to the person turning to representatives of the Church for help. When a woman/couple comes to the Church for guidance in such a situation, it might appear that they are looking for approval to have an abortion. Invariably, they are really looking for the strength, wisdom and support of the Church to help them to choose life for their baby.

"It is true that the decision to have an abortion is often tragic and painful for the mother, insofar as the decision to rid herself of the fruit of conception is not made for purely selfish reasons  or out of convenience, but out of a desire to protect certain important values such as her own health or a decent standard of living for the other members of the family. Sometimes it is feared that the child to be born would live in such conditions that ft would be better if the birth did not take place. Nevertheless, these reasons and others like them, however serious and tragic, can never justify the deliberate killing of an innocent human being. (emphasis in text) (The Gospel of Life,58)

Over the past six months two pastors called the Pro-Life Off ice for consultation regarding couples who chose abortion because of fetal defect and brought the deceased baby's remains to the Church for burial. The Church responds with the same love and care due to any family faced with the grievous death of a child. It is essential to provide the appropriate funeral rites and prayers for the deceased child. It is also important, in order to prevent scandal or misunderstanding, that we not communicate approval or support for the act of abortion which led to the death of the child. This requires great pastoral skill and care. It is likely, due to the fact that some hospitals now treat such abortions as a form of necessary infant death, that we will see more situations like this in the parish.

The Pregnancy Help staff is an excellent resource for consultation, referrals and direct counsel and support of pregnant women and family members. We have received feedback from clergy and other pastoral care providers that it is especially helpful for pastoral care givers to consult with Pregnancy Help before meeting with a pregnant woman or couple to be better prepared for their questions.

Upholding the Church's foundational teaching on respect for human life and dignity is often not easy, especially for those entrusted as pastoral care ministers. Yet, it is ultimately living this teaching with love and confidence that will open the way for the Holy Spirit to inspire the civilization of love:

"The commandment 'You shall not kill,'even in its more positive aspects of respecting, loving and promoting human life, is binding on every individual human being. It resounds in the moral conscience of everyone as an irrepressible echo of the original covenant of God the Creator with mankind. it can be recognized by everyone through the light of reason and it can be observed thanks to the mysterious working of the Spirit who, blowing where he Wills (cf.Jn3.8), comes to and involves every person living in the world...." The Gospel of Life, (77)

 Resources for Consultation and Referral

Pregnancy Help - 617-782-5151

Pro-Life Office - 617-783-5410

Health Care Ministry - 617-789-2457

Pope John Center - 617-787-1900